High-grade cervical disease in adolescents with HIV
Massad LS, Evans CT, D’Souza G, Darragh T, Minkoff H, Henry D, Goparaju L, Muderspach LI, Watts DH.
To estimate the risk of high-grade squamous intraepithelial lesions (HSIL) in adolescents with HIV.
Materials and Methods:
Review of cervical cytology and biopsy results from women aged 20 years and younger obtained within 3 years of enrollment in a prospective multicenter study.
At enrollment, none of 132 adolescent participants (45 HIV seropositive and 87 seronegative) had HSIL or cervical intraepithelial neoplasia grade 2 or 3 (CIN 2,3). Eight (7%) of 123 women with follow-up developed high-grade disease after a median of 2.6 years of observation. The incidence of HSIL/CIN 2,3 was 2.7/100 person-years (4.8/100 person-years in HIV seropositive and 1.6/100 person-years in HIV seronegative women; relative risk = 3.1; 95% CI = 0.76-12.74; p =.13). No cancers were found in adolescents during the study.
The low incidence of HSIL or CIN 2,3 in adolescents suggests that optimal management is careful observation rather than preventive treatment of low-grade abnormalities